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This was the second ever LEPB (non graded) i ever got and in retrospect i do have to agree with the tutors assessment despite it not being particularly favourable is i believe and accurate reflection as to what i was capable of then, despite this reflection i still hold that maybe i could of done better despite that not being particularly likely. I do however still contest the "sat in a casual manner" as a stupid reason to lose marks, nor any real reason to make someone down, no patients care, i ended up asking the patient the next week if they noticed and they hadn't! making this comment even more frustrating. (OPS B2, B3, B4, C4,)

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One of the non graded LEPB's (third) that we got from tutors,  the feedback still sin't great but there are some points where i seem to be doing okay in regard to the positive feedback so i'm on the right sort of track i do feel however, that we should be getting more help from tutors in how to integrate both the osteopathic concepts and the orthopaedic testing as we keep being told we do too many tests yet are given no alternatives. I also contest their idea that the patients guitar playing would of majorly affected them as they only played for a couple hours twice a week. (OPS: A1, B1 B2, B3, B4, C4, C5)

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My first baby patient had returned to the clinic; I was really excited to see how things had progressed with this baby.  She was responding to treatment!  It turned out that this baby was lactose intolerant; and the mother reluctantly had to change from breast feeding to a special milk that her baby could digest.  This made a big difference and once this had been diagnosed there was a big improvement.  When we finished in the summer clinic this patient stayed in the clinic on a tuesday morning and I had to say goodbye as I would now only be in clinic on a wednesday afternoon.  She was transferred to a different student, however in January she returned to me when I started the tuesday morning clinic and I was pleased to see she had made huge progress.  In fact, we struggled that day to find anything 'wrong' and so I had my first experience of discharging a baby patient, with the proviso to come back if anything changed.
What would I do differently, with 3 months' more experience?
I think in my own clinic I would suggest she come back in 3 months' time for a check up.  Its difficult for parents always to know if there is anything wrong with their baby, after all they see them all the time.

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This was my second baby patient. This patient presented with a problem turning her head to the left as well as a possible feeding problem, as she was very slow feeding.  However, it turned out that this child had had quite a few epileptic fits in the first few weeks after delivery and had been prescribed medication to prevent any more fits.
What went well? My treatment to improve the head turning was successful, with some improvement after the first treatment (A1, B2, B3, C1, C2, C3, C7)
What could have been improved?  The baby probably should have been referred for a possible tongue tie as she was very slow to feed; however the parents did take her for a possible tongue tie and in the end it wasn't performed because of the epilepsy condition and it was felt she would have to learn how to feed again; it was only two months until she would be weaned so it was felt that this might be unnecessary aggravation of a baby that was quite content and making good progress developmentally even if she was small for her age.
What went well? This baby made good progress with my treatment to improve the neck movement.  I also had a discussion with the parents about the possible need for long term treatment (D7, D14, D17) due to the medication the baby was on suppressing her nervous system's development.  The parents were happy to continue treatment if this was of benefit to their baby.

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What did I find hard in year 1?
I struggled in all the practical courses.  I felt very unconfident and intimidated by being surrounded by people who seemed more confident than myself, although in retrospect, probably only a handful were very confident with their previous knowledge.  I struggled with these classes due to my poor anatomy knowledge (B3), and the inability to keep up with the anatomy we were learning at a very fast pace, in a 2D style, mostly, although the anatomy models were brought out at the beginning of a new section of the body. Although we had the privilege of going to prosection at Sussex university, in retrospect it was really too soon to have any real benefit, although it was useful, more frequent would be have been beneficial but probably impractical given the heavy timetable.
The practical exam results reflected my struggles in the practical courses (B1) and were a true reflection of not enough practice, as well as not understanding how the practical exams would be (B2); how much theory I would need to be able to remember in a stressful and very hot environment.
At the beginning of the third term I managed to get some mentoring to help with the technique course.  I managed to scrape a pass in this course and when it came to resitting the practical exams, again I received extra help to help me pass these exams second time around (B2).  This time my knowledge and understanding had vastly improved. My reflective write up that I had to do as part of the year 1 studies reflected these struggles completely (B3).
What did I do well in? Academically I managed quite well (B2, B3), especially the anatomy and the reflective essays; despite the initial struggle to learn all the anatomy week by week; when it came to the exams I managed to apply myself to the task of memorising enough anatomy that I passed this exam; as well as the physiology exam which was not as hard, due to the amount of similar information I had learned the previous year on the sports science course I had done (B2, B3, B4).

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Year 2 was a very hard year; the amount of study required was phenomenal; however I had been warned and I steeled myself for a lot of early mornings for practice and study every evening (B1, B2, B3, B4) so that I kept up with the studies.  There were a couple of 'flashes of brilliance' where I managed to do well in practical assessments during the year; however I still found practical classes hard and only a small amount on input would put my body out; I got used to my body being 'out' the whole time; I felt sleep deprived but I was very happy I had made it to year 2; I even managed to get some more mentoring for the first term of the second year so that helped boost my confidence as well (B1, B2, B3, B4).  I studied very hard and I was very determined to get through the year; however towards the end of the year I think the exhaustion I was feeling played its part in failing some of the coursework.  Frustratingly, I failed one practical exam by;  however I resat this exam and passed it the subsequent time (B2, B3, B4).

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It had been a hard year and I had worked so hard during the year, practising every day and studying virtually every evening. I had been so determined to pass all the practical exams at first sit.  However, I failed the technique station by only a few%  I couldn't believe it.  However, I resat the exam and waited, quite anxiously for the results.
I felt so relieved. when I received the email telling me I had passed and I had progress to year 3.  It had been an anxious couple of weeks, waiting for the results (B2, B3, B4) despite trying not to think about the resits, it was hard not to go over in my mind how it had gone, would it be good enough, would I have to redo the technique exam, again, possibly.  Luckily that was not necessary (B1, B2, B3, B4).  A few days away in North Norfolk to recuperate was a good end to the holidays; ready to start year 3.  It was quite nerve wracking thinking in only a few weeks' time, I would be having patients!  Despite the fact that this was the whole reason for doing the course, I was dreading having my first patient and what I would have to do with that patient; I felt completely unprepared for this day that was approaching all too quickly.

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The pace was heating up as we reached the end of year 3; there was a need for some heavy, concentrated cramming to pass the theory exams (B2, B3, B4).  I was determined to pass all the exams this year.  The holidays were reduced as we would be in clinic for 5 weeks so I did not want to spend extra time revising year 3 coursework. However i had unfortunately created a perfect storm for myself managing to fail seemingly a small bit of everything, leading me to resit the year, however, when the discussion was being had about resitting the year, it was brought up that a common theme of my writing seemed to indicate a form of dyslexia, as there were continual lack of punctuation and many simple words spelt incorrectly. This lead me to getting a dyslexia assessment and appealing the decision

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The start of clinic and more academic work

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The start of clinic and more academic work

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Focusing on my relationship with my girlfriend for the first two years had left me rather isolated from the rest of my year group. I had no specific person that I could call a friend. Something I have since tried to remedy in year five by talking to people outside of clinic via Facebook and WhatsApp. I have been making an effort to get involved in group activities with this new year group, something that has helped with my peer support and made me feel more involved with osteopathy.
The first few months of third year were a miserable affair for me I had started struggling deeply with anxiety and mental health issues making my attendance into lectures very poor, something which unfortunately continued throughout the year, due to the strained relationship I was in.

Although initially we had a gradual start to year 3 (they were kind to us initially), the pace began to increase again as the pressure was increased, dissertation presentations were looming and there seemed to be no time to learn all the information being thrown at us as well as do the required coursework (B2, B3).
Something needed to happen quickly, to relieve the pressure. The Beast from the East arrived, and lectures and clinic was cancelled.  I was very thankful to have this little breather, to enable me to catch up and start writing my presentation for my dissertation proposal (B2, B3).
What would I have done differently, without the Beast from the East?
I think to begin with, there was a little bit of 'putting off' of the presentation: I knew I would find it hard and it was one of those things that until you start doing it, you are not sure how hard it will be, but nearly always, you are pleasantly surprised and it is not as hard as you think it will be: normally it is harder in your head than it is in reality (B2, B3, B4).
There would have been more work at the weekends although there was a fair amount of that already.  What the Beast from the East did though, was concentrate my mind: I was 'trapped' indoors with a golden opportunity to get to grips with somethings I knew I would find difficult.
It was hard, but it was manageable and achieved in reasonable time too.  The Beast also made me decide to stay in Kent more than I would have done usually; with the roads being icy it was a good decision to stay in Kent and make the most of extra study time made available to me by fewer distractions being thrown to me.

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I have been getting a lot of enjoyment from the children's clinic.  However, I found it very 'scary' despite the supportive environment.  It isn't as easy feeling the IVM on babies as I had imagined.  However, I was told I had excellent palpation and that I had a real talent.  I felt very complimented.  It gave me more confidence hearing that from the tutor too.
What did I struggle with?
However, I still hate fill in the learning action plans.  I think I find it easier being led by the clinical experience; or probably I should fill in the learning action plan as I go so that I don't forget what I need to concentrate on; in fact I tend to know what I struggle with when I make myself think about these things: differential diagnoses; red flags; neuro screens.
What has improved? I have been trying to make these more conscious so that they are more in the forefront of my head and so I have something to grab onto when I am making differential diagnoses.
I think I will always struggle to fill in these forms however I think I am becoming more honest with myself in my shortcomings and recognising what I need to improve upon.

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Dissertation - a reflection of the process

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Dissertation - a reflection of the process

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My dissertation original proposal had to go through various rewrites eventually having to be scrapped when the institutions I contacted never responding and the exam appeal forcing me to abandon the entire premise of a questionnaire style dissertation, even with all this my dissertation was handed in on time partially in thanks to starting the day that I found out I had to change to a literature review.
I found the process of writing the dissertation very hard (B2, B3, B4).  However I enjoyed all the reading I did in preparation for it and requesting further articles from the library; the process of detective work was good and I felt as though I was hunting down articles (B2, B3, B4); although this process was definitely frustrating when I couldn't access articles through Greenwich at the weekends. If I could just have done the reading for it and left it at that I would have been quite happy (B2, B3, B4).
What was difficult?
I found it ate into so much time; I would have preferred to spend this time on clinical matters.  I found I was quite resentful of the time that I had to spend on it.  Initially my dissertation was going to be a qualitative study about the opinions of the use osteopathic technqiues between british and american osteopaths; I had wanted to used a questionaire that took their opinions however I was unable to get access to any american osteopathic members so this ended up being a non-starter (B2, B3, B4).
What went well?
I decided before it was too late to change tack completely and do a literature review instead.   This was a very good decision and I probably should have changed tack even sooner but I was reluctant to do a literature review (B2, B3, B4).  Immediately I felt as though a weight had been lifted off my shoulders and I was back in control, no longer needing people to contact me (B2, B3, B4).
What could I have done better and how would I do it again?
I should have abandoned the original dissertation proposal earlier when I hadn't heard from any of the american osteopathic organisations within a week (B2, B3, B4).
As I delayed the change of topic it was a rush to the end, not helped by being quite ill; I felt so rough just one week before the deadline for the hand-in, which meant I had to struggle on with the finishing off the dissertation when I had very little energy.  It was a very hard process mastering writing of the dissertation and I think it is unlikely I would ever write another one; I found it very painful; but it made me very focussed on the topic in hand and I learned a great deal and it may come in useful in future.
The process of having to reapeat the dissertation was frustrating especially as there was relatively few mistakes that needed to be corrected, most of my resubmission was rearanging the positioning of the text i had already written and expanding slightly on materials i had written already, leading to the whole process taking only a few hours in total, mostly adding to the frustration of the resat year.
The writing of the literature review underlined the problems of standardisation in Osteopathy. As unlike drug trials it is impossible for the same sort of double blind trials to be carried out. The lack of a sound research base hinders Ostepathy's development as a profession.

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This was the second ever LEPB (non graded) i ever got and in retrospect i do have to agree with the tutors assessment despite it not being particularly favourable is i believe and accurate reflection as to what i was capable of then, despite this reflection i still hold that maybe i could of done better despite that not being particularly likely. I do however still contest the "sat in a casual manner" as a stupid reason to lose marks, nor any real reason to make someone down, no patients care, i ended up asking the patient the next week if they noticed and they hadn't! making this comment even more frustrating. (OPS B2, B3, B4, C4,)

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The first ever question as to my abilities came in 2006 with my parents taking em to see and educational psychologist who described me as borderline dyslexia which couldn't really be put down entirely to "yes he has" and "no he hasn't" which to me makes me wonder how my educational experiences would of been different if i had only had more tests done earlier. (OPS B3, B4, C8, D3, D10)

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This was the report which finally confirmed that i wasn't "normal" in the learning sense i didn't process information in the same way as others making my learning process a lot more difficult than it needed to be. I place this and the other report in OPS A as i believe that it helps me to understand patients better as well as helping me to understand a way in which i can communicate with patients. (OPS B3, B4, C8, D3, D10)

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Overall not to bad for what i normally get in these types of exams not breaking any records but more than enough to pass. (OPS B1, B2, B3 C3, C4, C7, D3)

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Not to massively different from year one maybe a little lower but that doesn't surprise me with the course load being so much heavier this year and the exams being much more numerous (OPS B1, B2, B3 C3, C4, C7, D3)

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Eventually passing after drama with the appeal and the dyslexia assessment again still not to far off the results from the other two years something i can live with, although the thought that i could have gotten much better grades with the addition of a dyslexia assessment will always be in the back of my mind. (OPS B1, B2, B3 C3, C4, C7, D3)

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This is a compendium of the cases which i feel have most informed my time in osteopathy and my osteopathic development so far, i look back upon with a realisation that there are no patients i have actively dislike or not gotten along with, nor many cases where i felt hopelessly lost or with no idea what was going on. However, when writing this i certainly felt a flood of emotions rushing back in regards to some patients and the lives they lead.

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A reflective piece on the unofficial 5th year and a lookback on a realtionship

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I had originally decided to try and mark down information in a way that made sense to me and collating conditions into these groups massively helped me to understand conditions and how they can mask themselves as other conditions or present information which will lead you to the wrong conclusion. i also ended up sharing this with quite people in the class as an attempt to help as many with my work as i could as i personally found this when read out to be immensely helpful. Now while both old and new versions of this document i do say contain the requirements for the OPS stated i argue to the extent of those particularly those in the B section as while i have included information in both the newer version contains more and better levels of information. (OPS: B1, B2, B4 C2, C3, D1, D3, D2, D8)

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Refer to Hips (below this post) for information (Originally created in year 2 along with a host of other lists but i'm just showing this one for brevity as they all follow the same type of pattern as these two)

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I was actually pleasantly surprised at these results, this might be due to the fact that this exam focused purely on my physical skills and patient handling rather than any verbal communication with the examiner. (OPS A1, A4, B1, B2, B4, C2, C3, C4, C7, D3)

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I include this in C as it was my first time making clinical decisions purely on my own without support or help from tutors or friends and while i feel i don't think i did too badly given the acuteness and intensity of the case i still ended up with less than i should of which will always be an annoyance especially as it pushes up the marks i need for CCA 2 to 52% which while not a huge increase is still an increase making it just that little bit harder. Verbal feedback i got from the tutors also talked about how while my communication with the tutors was poor my communication with the patient was very good and the way that i talked with them about i wanted to keep expectations in check was a very good point. (OPS: A1, A2, A3, A4, A5, A6, B1, B2, B3, C2, C4, C5, C7, C8, D1, D6, D7, D8)

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One of the many issues I’ve had with this course is the schedule, the course seems to put all of its exams and coursework to be done right at the very end or in short bursts meaning you had these incredibly long periods of nothing and then everything all at once or with periods of high intensity with gaps between them which lead more to a continual up time rather than allowing for time inbetween to relax and recover as by the time you were finished with an exam or coursework it would be time to start preparing for the next exam. This is something I really struggled with and this 5th years incredibly low level schedule has helped me make many strides in working on my own mental health and confidence something I am immeasurably greatful for

Something that I will look forward to in regards to CPD’s is the fact I can more or less choose the times that work for me, meaning I can actually chose times where I know I’m going to be more receptive to learning or times where I know there will be a lull in life demands upon me, meaning I can learn much more at my own pace.

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My previous journey before this course had been a much more relaxed and undirected affair. Before this, I had been only been in school doing a lot classes that I otherwise did not enjoy and while I knew I wanted to be an osteopath the road towards it seemed long and filled with pointless distractions. It was only really when I started my sports science course at Oaklands that I actually felt like I starting to do a course that was more tailored to what I enjoyed and wanted to do.

I believed that this course would merely be an extension from what I have done previously in college, but I was massively wrong. The course delved in much deeper into all aspects of the human body and mind than I was expecting. Writing this essay brings up all the feelings of dread and exhaustion that I have ever felt with the education system. For the most part it has been an incredibly educational time helping me to learn more about the human body and consider it in ways that I hadn’t before adding in connections and relationships previously unknown to me. It has also shown me that as a species we are a generally good people, we may each hold our own ideals and beliefs but for the most part people are content to life their lives. I think this is important especially in the health care business, you will always come up against arrogance, loneliness, hardship, wealth problems, patients’ internal battles as well as your own, stupidity, sadness and the process of reflection may help to pick it all apart and allow a way of differentiating and understanding the complexities.

I originally decided that I wanted to be an osteopath when I was only 10, purely because I went with my mum when she was getting treatment and they way that osteopath had described their job to me made it seem like a perfect job, you get to be your own boss, help people, chose your hours and best of all for me not being stuck behind a desk for hours.

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Looking back at the time at the ESO I find myself struggling to see how I got here despite having it all laid out for me in this essay and on the padlet It does feel like a very long time ago and very recently that I started this journey, I look back at the points where I feel like I’ve improved and points where things started to make sense to me and find that very few times have I felt that I was lost something I am glad for.

Summer clinic was I feel a turning point in my practical abilities and abilities to talk to tutors and give instruction to patients. I have been able to apply a different learning style due to my dyslexia, audio now prevails massively in my ability to revise and develop my skills (OPS B). I will also continue to improve with my differential diagnosis through continuingly reading articles that catch my attention and will help keep me up to date and informed in the world of medicine (OPS B, C, D).

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I was diagnosed with Pompholyx in December of the first year, a form of eczema heightened by stressful periods, forcing to being to take topical steroids in the form of betamethasone valerate in order to control, something I still need to do to this day, I didn’t really want to take it when I started however I quickly found that the medication was incredibly helpful in controlling my condition. Looking back it gives me an insight into what patients must feel when presented with medications which will help them, and also gave me a greater understanding of the effects of stress as well the annoyance caused by long term conditions. It also caused me to pay attention to cuts on my hands and to clean up any burst blisters with disinfectant and plasters (OPS C 4 5 D11).

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This is one of the major issues that face any medical practioners in these times, making sure that people not only understand about certain technqiues may require additional consent but that they understand what they are agreeing to as well as udnerstanding their diagnosis and the reasoning for their treatment. This is thankfully something i've never really had much trouble with multiple tutors have said its one of my best points that i gain consent for every techinque and give an explanation for what i want them to do, with one tutor commenting that "You do it to the point of exhautsion" which overall i consider a good thing, it means the patient is informed and know what i'm planning to do. (OPS A1,A3,A4,)
I've also been attempting to make sure that i p[rovide patients with the chance to chose their treatment options by giving them different treatment options that will effectively do similar things but allow the patient some freedom and allow them to feel they are controlling their own treatment as well as helping to avoid positions that they find uncomfortable whereever possible. (OPS A2, C4)

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One of the weirder points of this year was the psychology presentation. This involved us presenting something in front of a tutor and also submitting a piece of written work. The tutor and the students I presented to, complimented my actual presentation and said they found it incredibly informative. However, a large proportion of the marks were given for the actual written submitted piece and because I had learnt most of it, rather than writing it down, it ironically made my marks lower.

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I expected to feel trepidation and fear, about the future but I find myself instead with a feeling of, bring it on and hurry up. I had made huge strides in my learning and practise. I felt ready to leave the education system and start earning a living without worrying about exams or portfolio hand it dates. It genuinely felt like the last mile of a marathon. Summer clinic was a turning point, giving me some of the best experiences in clinic I've had and alleviating a lot of my worries about practice.

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Unfortunately, the demands on my time from my partner in the relationship I was in, gave little time to revise, or repeat the content to retain it.